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Dr. Thomas Davidson

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Guest Editor

Department of Health and Medical Sciences, Linköping University, Linköping SE-58183, Sweden
Interests: health economics; cost-effectiveness; outcome measure; health technology assessment; oral health

Special Issue Information

Dear Colleagues,

Caries is globally the most prevalent noncommunicable disease, causing pain and detracting from quality of life. Although it is a chronic multifactorial disease, caries is largely preventable through a combination of measures at individual, professional and community levels. Once the disease is established there is increased risk of further progression, and this takes its toll, from both health and economic perspectives.

Health economic evaluations provide decision makers with important information. This input is important when the aim is to use scarce resources efficiently. It is also of value for development of guidelines and funding of research. To provide dentistry with relevant health economic evaluations, there is a need of studies on both its costs as well as its outcomes (presented in terms that enables a decision maker to prioritize effectively). There is furthermore a need for simulation models that can analyze methods from different time horizons and perspectives. Furthermore, health economic evaluations of caries would also benefit from estimating QALY values for various health states.

Dental caries is unevenly distributed in society and there is evidence, in both children and adults, of an association between socioeconomic status and dental caries. The same pattern occurs regionally, nationally as well as globally: the oral health of the socially disadvantaged is poorer than that of those with better living conditions. For all levels of society to have good dental health, effective oral health preventive interventions need to be implemented. Economic evaluations of caries preventive methods may help to get there.

Papers addressing these topics are invited for this Special Issue.

Dr. Thomas Davidson
Guest Editor

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Keywords

Health economics
Economic evaluation
Costs
Cost-effectiveness
Willingness-to-pay
Health technology assessment
Oral health
Quality of life

Published Papers (2 papers)

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Research

10 pages, 634 KiB

Open AccessArticle

Long-Term Cost-Effectiveness through the Dental-Health FRAMM Guideline for Caries Prevention

by Thomas Davidson, Eva-Karin Bergström, Magnus Husberg and Ulla Moberg Sköld

Int. J. Environ. Res. Public Health 2022, 19(4), 1954; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19041954 - 10 Feb 2022

Cited by 1 | Viewed by 1799

Abstract

A guideline called FRAMM, which is an acronym in Swedish for the most important parts of this guideline, namely “fluoride”, “advice”, “arena”, “motivation” and “diet”, was implemented in 2008 in the Västra Götaland Region in Sweden. This guideline included fluoride varnish applications performed at school twice a year at six-monthly intervals for all 12- to 15-year-olds, together with lessons on oral health. The aim of this analysis was to estimate the long-term cost-effectiveness, using prognostic calculations, of the FRAMM Guideline for 12- to 15-year-olds, compared with routine care, until the participants were 23 years old. A cost-effectiveness analysis was performed from a health care perspective, based on four years of verified data and seven years of prognosis. Data from FRAMM were combined with cost data from price lists in Sweden. The cost-effectiveness was analyzed by relating the difference in costs to the difference in the number of approximal surfaces with fillings and/or dentin lesions (DFSa). The analysis shows that FRAMM was considered dominant compared to the controls in all alternative scenarios, hence costs were prognosed to be lowered and outcomes were prognosed to be improved. A dental health program like the FRAMM Guideline with fluoride varnish during the caries risk period from 12 to 15 years is predicted to be cost-effective in the longer perspective. To further study the actual long-term caries increment after a preventive dental health program would be of great interest to verify these results. Full article

(This article belongs to the Special Issue Economic Evaluation and Caries Prevention)

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13 pages, 728 KiB

Open AccessArticle

Socio-Economic Status May Associate Different Risk(s) with Early Childhood Caries (ECC) That Can Cause the Development of Psychomotor Deficiency in Preschool Children Aged 3–6 Years Old: The Results of Preliminary Analysis from a Cohort Study

by Andy Yen-Tung Teng, Chen-Yi Liang and Yen Chun Grace Liu

Int. J. Environ. Res. Public Health 2021, 18(17), 9011; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18179011 - 26 Aug 2021

Cited by 4 | Viewed by 2097

Abstract

Background: We have recently shown that there is a positive correlation between severe caries and developing psychomotor deficiency in preschool children. To fully re-assess such a relationship, we embarked on a 3-year longitudinal follow-up study of kindergarteners, where we aimed to: (i) confirm whether early childhood caries is causally related to the development of psychomotor deficiency as proposed, and (ii) address any significant role or contribution of socio-economic status associated with caries–psychomotor interactions in the preschooler family cohorts studied, over time. Methods: A longitudinal study was designed where the total sum of 159 kindergarteners aged 3–6 from the central and southern regions of Taiwan were randomly selected and recruited for clinical examination of caries, together with questionnaires for personal, demographic and dietary information, socio-economic status, and the children’s psychomotor development scales which were collected and analyzed over time. Student’s t test, chi-squared test, correlation coefficients, and multiple linear regression analysis with R² determinants were employed to assess any attributable differences (of 0~1) between SES vs. psychomotor manifests and caries measured among all variables computed. Results: The results of our preliminary analyses show that: (i) there was likely a causal relationship between caries activities and aspects of general development scale via the Chinese Child Development Inventory over time (4.01 ± 3.47 vs. 5.88 ± 2.58, respectively) in the 3–6-year-old preschoolers, and (ii) there was significantly more attributable influence (via higher R-squared values) from SES and psychomotor manifests than that of caries and the Chinese Child Development Inventory counterparts, as detected over time. Conclusion: Collectively, the resulting analyses support our previous findings and confirm that there is likely a causal relationship between severe caries and psychomotor deficiency in growing preschoolers; the resulting analyses revealed that such causally related interactions may be attributably explainable by a content-reliant association via socio-economic status analyzed in the kindergartener family cohorts studied. Thus, the socio-economic status or its constituents/factors will have a much broader influence not only associated with developing early childhood caries (a biologic trait), but also for psychomotor deficiency (a social trait) in vulnerable children at risk. Full article

(This article belongs to the Special Issue Economic Evaluation and Caries Prevention)

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